Nokea
The healthcare provider prescribes terbutaline (Brethine) for a client in preterm labor. Before initiating this prescription, it is most important for the LPN/LVN to assess the client for which condition?
- A. Gestational diabetes.
- B. Elevated blood pressure.
- C. Urinary tract infection.
- D. Swelling in lower extremities.
Correct Answer: A
Rationale: The correct answer is A: Gestational diabetes. Terbutaline (Brethine) is known to cause hyperglycemia, so it is crucial to assess for gestational diabetes before administering it. Assessing for elevated blood pressure (choice B), urinary tract infection (choice C), or swelling in lower extremities (choice D) is not directly related to the potential side effect of terbutaline in causing hyperglycemia.
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A postpartum client who is Rh-negative refuses to receive RhoGAM after the delivery of an infant who is Rh-positive. Which information should the nurse provide this client?
- A. RhoGAM prevents maternal antibody formation for future Rh-positive babies.
- B. RhoGAM is not necessary unless all of her pregnancies are Rh-positive.
- C. The Rh-positive factor from the fetus threatens her blood cells.
- D. The mother should receive RhoGAM when the baby is Rh-negative.
Correct Answer: A
Rationale: The correct answer is A. RhoGAM is administered to Rh-negative individuals after exposure to Rh-positive blood to prevent the development of antibodies that could harm future Rh-positive babies during subsequent pregnancies. By refusing RhoGAM after the delivery of an Rh-positive infant, the mother risks developing these antibodies, which could lead to hemolytic disease in future pregnancies with Rh-positive babies. Therefore, it is crucial for the nurse to explain to the client that receiving RhoGAM prevents the formation of maternal antibodies against Rh-positive blood, safeguarding the health of future babies. Choices B, C, and D are incorrect. Choice B is incorrect because RhoGAM is necessary after exposure to Rh-positive blood, regardless of the Rh status of future pregnancies. Choice C is incorrect as it does not accurately convey the purpose of RhoGAM administration. Choice D is incorrect because RhoGAM is specifically given after exposure to Rh-positive blood, not when the baby is Rh-negative.
Using N¤gele's rule, what is the estimated date of delivery for a pregnant client who reports that the first day of her last menstrual period was August 2, 2006?
- A. April 25, 2007.
- B. May 9, 2007.
- C. May 29, 2007.
- D. June 2, 2007.
Correct Answer: B
Rationale: N¤gele's rule is used to estimate the date of delivery. It involves adding 7 days to the first day of the last menstrual period (August 2), which gives August 9. Then, subtracting 3 months from August 9, we arrive at May 9 of the following year as the estimated date of delivery. This makes choice B, 'May 9, 2007,' the correct answer. Choices A, C, and D are incorrect as they do not follow the correct calculation based on N¤gele's rule.
When a client delivers a viable infant but experiences excessive uncontrolled vaginal bleeding after the IV Pitocin infusion, what information is most important for the nurse to provide when notifying the healthcare provider?
- A. Maternal blood pressure
- B. Estimated blood loss
- C. Length of labor
- D. Amount of IV fluids administered
Correct Answer: A
Rationale: In a situation where a client is experiencing excessive uncontrolled vaginal bleeding post-delivery, the most crucial information for the nurse to provide the healthcare provider is the maternal blood pressure. Maternal blood pressure can help assess the severity of the bleeding and guide immediate interventions to stabilize the client's condition. Estimated blood loss, length of labor, and amount of IV fluids administered are important pieces of information but in this scenario, maternal blood pressure takes precedence as it directly indicates the client's current hemodynamic status.
A full-term infant is transferred to the nursery from labor and delivery. Which information is most important for the LPN/LVN to receive when planning immediate care for the newborn?
- A. Length of labor and method of delivery.
- B. Infant's condition at birth and treatment received.
- C. Feeding method chosen by the parents.
- D. History of drugs given to the mother during labor.
Correct Answer: B
Rationale: When a full-term infant is transferred to the nursery, the most crucial information for the LPN/LVN to receive for immediate care planning is the infant's condition at birth and any treatments received. This data helps in determining the initial care needs and monitoring requirements for the newborn. Choices A, C, and D are not as critical as the infant's condition at birth and treatment received. The length of labor and method of delivery may provide background information but may not be as essential for immediate care planning. The feeding method chosen by the parents and the history of drugs given to the mother during labor are important but do not take precedence over knowing the infant's condition and treatment received.
At 20 weeks gestation, a client is scheduled for an ultrasound. In preparing the client for the procedure, the nurse should explain that the primary reason for conducting this diagnostic study is to obtain which information?
- A. Sex and size of the fetus.
- B. Chromosomal abnormalities.
- C. Fetal growth and gestational age.
- D. Lecithin-sphingomyelin ratio.
Correct Answer: C
Rationale: The primary reason for an ultrasound at 20 weeks gestation is to assess fetal growth, gestational age, and anatomical development. This evaluation helps ensure the fetus is developing appropriately and can detect any potential issues that may require intervention. Choices A, B, and D are incorrect because at 20 weeks, the primary focus of the ultrasound is not to determine the sex of the fetus, detect chromosomal abnormalities, or assess the lecithin-sphingomyelin ratio. While these factors may be evaluated in pregnancy, they are not the primary reasons for an ultrasound at 20 weeks gestation.